Zero in on proper code with hernia glossary-of-terms.
Reporting hernia repair requires so much anatomy and physiology know-how that it's enough to confound even the most seasoned surgery coders.
Use our two handy tools to help you pick the right ICD-9 and CPT® codes -- every time.
Tool 1: Anatomy and Diagnosis Chart
Use the following anatomy drawing and diagnosis coding chart to help you perfect your hernia claims for now and for the future when you're required to use ICD-10.
Tool 2: Glossary of Hernia Terms and Procedure Codes
Clinicians identify hernias primarily by location as outlined in tool 1. But there's often more to it than location -- like how the hernia forms and the clinical significance of the specific condition.
Study the following hernia definitions to learn the laparoscopic and open repair procedure code ranges for each type:
Open: 49570-49572 (Repair, epigastric hernia ...)
Laparoscopic: 49652-49653 (Laparoscopy, surgical, repair ventral, umbilical, spigelian, or epigastric hernia ...)
Open: 49580-49587 (Repair, umbilical hernia ...)
Laparoscopic: 49652-49653
Open: 49491-49525 (Repair, ... inguinal hernia ...)
Laparoscopic: 49650-49651 (Laparoscopy, surgical, repair ... inguinal hernia)
Open: 49550-49557 (Repair, ... femoral hernia)
Laparoscopic: 49659 (Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy)
Open: 49560-49566 (Repair, ... incisional or ventral hernia ...)
Laparoscopic: 49654-49657 (Laparoscopy, surgical, repair ... incisional hernia ...)
Open: 43332-43337 (Repair, paraesophageal hiatal hernia ...)
Laparoscopic: 43281-43282 (Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed...)
For each code range, you may need additional information such as patient age and treatment encounter (initial or subsequent). Here are some more helpful terms you can use to narrow your code choice: